PB2453: FACTORS INFLUENCING AUTOLOGOUS PERIPHERAL BLOOD STEM CELL MOBILIZATION IN LYMPHOMA AND MULTIPLE MYELOMA
Authors: Ran Longrong, Peng Yu, Zhao Mingyu, Luo Xin, Chen Shuang, Yang Zailin
Journal: HemaSphere (2023)

Topic: 22. Stem cell transplantation - Clinical Background: Lymphoma and multiple myeloma (MM) are the most common hematologic malignancies. In recent years, with the continuous application of new methods and new drugs, the survival outcome of patients has been improved. Hematopoietic stem cell transplantation (HSCT) still plays an irreplaceable role in the treatment of lymphoma and MM, which can improve the prognosis of patients and significantly improve the overall survival (OS) and progression-free survival (PFS) of patients. Hematopoietic stem cells (HSC) can be isolated from bone marrow (BM), umbilical cord blood, or peripheral blood, due to collection of peripheral blood stem cells, HSC, PBSC, with lower cost, shorter hospital stay and faster transplantation, has become the main source of HSCT. Autologous stem cell transplantation (ASCT) is the major transplantation therapy for patients with lymphoma and MM, and the success of auto-HSCT depends on the mobilization efficiency of peripheral blood HSC. In clinical practice, CD34+ cell count in peripheral blood is often monitored to predict the collection effect and determine the collection time. Aims: To analyze the influencing factors of ASCT mobilization and collection in patients with lymphoma and MM, and to explore the clinical predictive value of peripheral blood related detection indicators and multiple indicators combined on HSC mobilization and collection results. Methods: Totally 108 patients with lymphoma and MM who underwent ASCT mobilization in Chongqing University Cancer Hospital from January 2021 to August 2022 were including in this study. There are two groups: collection success group and collection failure group. The influencing factors of peripheral blood HSC mobilization and the influence of peripheral blood related detection indexes before mobilization on the collection results were retrospectively analyzed. And further analyzed the changes of peripheral blood related detection indexes before and after the remobilization of prexafol in patients with poor results of routine mobilization. Results: There were no significant differences in gender, disease type, disease stage, age, disease status before mobilization, mobilization medicines and number of chemotherapy courses between the two groups (P > 0.05). However, compared with the collection failure group, the proportion of patients with mobilization days less than 5 days was increased in the successful group (P < 0.05). The analysis of peripheral blood detection indexes showed that compared with the collection failure group, the contents of peripheral blood white blood cells (WBC), lymphocytes (Lym), monocytes (Mono), neutrophils (Neu) and hemoglobin (Hb) in the collection success group had no significant differences (P > 0.05). However, the peripheral blood platelet (PLT), mononuclear cells (MNCs) and absolute CD34+ cell count in the successful collection group were significantly increased than those in the collection failure group (P < 0.05). Combined detection of three indexes shows high sensitivity (86.6%), specificity (89.3%) and with an AUC of 0.939 for predicting of the success of HSC collection. The count of peripheral blood platelets, MNCs and CD34+ cells increased significantly in patients treated with prexafol. Summary/Conclusion: Peripheral blood PLT, MNCs and CD34+ cell count before HSC collection can reflect the mobilization of HSC in patients with lymphoma and MM. The combination of the three indexes can improve the accuracy of predicting the success of HSC collection. Patients with less than 5 days of mobilization have a higher success rate of HSC collection. For patients with poor mobilization effect, prexaffor can be used for further salvage mobilization.Keywords: Multiple myeloma, Lymphoid malignancy, Bone marrow transplant